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Enhancing Nutrition in Late-Stage Alzheimer's Disease

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Updated May 22, 2008

Photo © Administration on Aging

Photo © Administration on Aging

We all require adequate nutrition and hydration in order to stay healthy, but those with late-stage Alzheimer's disease are at a higher risk for malnutrition because of problems with eating and swallowing. Additionally, those with swallowing difficulties can breathe liquids or food particles into the airway and lungs, putting them at an increased risk for developing pneumonia. If your loved one has late-stage Alzheimer's, the following strategies can help him or her eat and drink safely:

  • Create a calm, quiet eating environment. It might be tempting to turn on the TV or radio while helping your relative eat, but the noise can be distracting for those with late-stage Alzheimer's. Have your loved one eat in a calm, quiet place, using a simple table setting if he can still use utensils.

  • Make sure your relative is comfortably seated. She should be seated upright while eating and should stay upright for at least 30 minutes after eating in order to aid digestion.

  • Be patient and adaptable. Eating will take longer during the late stage of Alzheimer's disease, so try to allow plenty of time for meals. Over time, you might have to make adjustments to your loved one's changes in food preference or amount of desired food. People with late-stage Alzheimer's sometimes eat more if they're offered smaller meals or snacks throughout the day, rather than three larger meals.

  • Choose easy-to-swallow foods. Provide soft foods that are easy to chew and swallow, such as pudding and mashed potatoes. Bite-size and finger foods, such as cubes of cheese, also work well. If your relative no longer eats solid food, try mashing it up or pureeing it in a blender.

  • Encourage fluids. Alzheimer's disease sometimes affects people's ability to realize they're thirsty, so it's important to provide frequent opportunities to drink liquids. If swallowing water is difficult, try offering fruit or vegetable juice, soup or yogurt, which are all water-based. You can also try thickening liquids by adding cornstarch or unflavored gelatin.

  • Be prepared for choking problems. Since late-stage Alzheimer's often includes swallowing problems, coughing and choking are serious risks during meals. Learn how to do the Heimlich maneuver and be prepared for choking emergencies.

  • Encourage, then help. Even during late-stage Alzheimer's, some people can still feed themselves to some degree when given cues and encouragement. Try guiding your loved one through the first bite and see if this prompts self-feeding. If your relative can't feed himself, offer food and beverages slowly, making sure that everything is swallowed before offering the next bite or drink. Reminders to chew and swallow can move the process along.

  • Get referrals for speech and swallowing therapists. Your primary care doctor can guide you to these therapists, who can watch your relative swallow and make further recommendations regarding how to swallow and what types of foods are appropriate for them at this stage.

Sources:

Alzheimer's Association (2005). Late-stage care: Providing care and comfort during the late stage of Alzheimer's disease. Chicago, IL: Author.

Mace, N. L., & Rabins, P. V. (2006). The 36-hour day: A family guide to caring for people with Alzheimer disease, other dementias, and memory loss in later life (4th ed.). Baltimore, MD: Johns Hopkins University Press.

National Institutes of Health (2008). End of life: Helping with comfort and care (NIH Publication No. 08-6036). Washington, DC: U.S. Government Printing Office.

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